Most of us probably know what it looks like on the inside of a psych hospital, though probably more from movies than experience.  The Funny Farm (or Nut House or Looney Bin, etc.) has been represented well in film and on the page.  It’s really no mystery: psych wards tend to look like most other hospital wards, with a few slightly different—but enormously important—differences.  The locked entrances, the barred windows, for example.

In popular culture, the euphemisms are many and the fear is real:  no one wants to end up in such a place, held hostage and forced to take pills or injections that contain god knows what.  We fear running into a Nurse Ratchet; we fear electric shock therapy.  We fear being locked up in a padded room.  But, most of all, we fear losing our minds.

Interiors in psych wards aren’t necessarily what the focus should be when talking or writing about psych wards.  Physical conditions have certainly improved; if you read descriptions of insane asylums from Michael Ondaatje’s Coming Through Slaughter, you have reason to fear. “Women patients not properly clothed.  Cells had no heat.”  Other indications of less than stellar conditions were the ward names:  Untidy Wards, Closed Wards, Violent Wards.

The internal goings-on of the patients inside these psych wards are much harder to nail down.  There are a multitude of memoirs about being on the inside, and there are narratives that do describe a certain mental state.  I’ve read many such memoirs, but the best description I’ve read so far of depression is in a work of fiction.  Except:  the author was struggling with depression.  Except:  the author committed suicide.  So, in a very real way, the description I’m referring to is entirely and possibly 100% accurate and true.

The book is Infinite Jest; the author is David Foster Wallace.

Years in Infinite Jest are corporate sponsored; instead of a numerical year, you have things like “Year of Glad” or “Year of the Depend Adult Undergarment.”  It’s in the YDAU that we meet a young woman named Kate Gompert.  Kate is in the psych ward, after having overdosed on all of her anti-depressants.  Like over one hundred pills.

The doctor asks Kate why she would want to ‘hurt’ herself; she tells him she wasn’t trying to hurt herself, but was trying to kill herself.  “There’s a difference” she explains.   There certainly is.  And this is the crux of my interest in this chapter, in this particular description of depression:  it’s not an attempt to hurt oneself; it’s an attempt to stop the hurting that is currently going on.

As Kate puts it, in trying to explain this feeling to the doctor:  “Do you understand?  It’s not wanting to hurt myself it’s wanting to not hurt.”

This also points to the fact that being depressed isn’t necessarily being super sad, it’s being in a great deal of pain.  Emotional pain doesn’t register as serious with those who need visual evidence; there’s nowhere to point when a person is in emotional pain.

Other comments, made by the unknown narrator, relate more of what a depressed person’s mind is like:  “Their normal paralyzed stasis allowed these patients’ own minds to chew them apart.”  Kate further describes her depression as more than just a “state”—she says “This is a feeling.  I feel it all over.  In my arms and legs.”

The thought of your own mind chewing you up is unpleasant and incredibly accurate.  This description could only come from one familiar with depression, someone who has seen the inside of the psych ward, one who has tried all the pills, one who has had his mind chewed up for years on end.  And it’s a description that speaks to the reader who has experienced the same.

The first chapter of Infinite Jest (which is actually the last chapter, but appears first physically), describes the internal state of Hal, the young tennis prodigy.  Hal attempts to communicate his inner self to school board members and the result is both hilarious and terrifying; they believe he is having seizures.  He believes he is speaking eloquently and intelligently.  That futile attempt at communication can be summed up in Hal’s repeated thought:

I am in here. 

I think of this line often, so often that I have thought of having it tattooed on my arm.  It foreshadows the struggle of Kate (and others) to find a way to articulate that inner landscape, to find a way to speak about what gnaws at the inside of your mind.